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General NPI Number Information
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NPI Number | 1184048621
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Entity Type | Organization
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Legal Business Name | CANAL FULTON CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 2186 LOCUST ST S
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City | CANAL FULTON
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State | OH
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Zip | 44614-9468
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Country | US
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Telephone | 330-408-7550
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Fax | 330-408-7560
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Provider Business Mailing Address
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Address Line | 2186 LOCUST ST S
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City | CANAL FULTON
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State | OH
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Zip | 44614-9468
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Country | US
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Telephone | 330-408-7550
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Fax | 330-408-7560
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. NICHOLAS A SHIFFLET
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Credential | DC
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Telephone | 330-408-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4207
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License Number State | OH
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